Nourished and Protected

Bryce J. Christensen and Robert W. Patterson

Professing the best of intentions, many activists fighting child abuse and neglect warn, “Anyone might be an abuser.” To be sure, state officials have uncovered alarming cases involving unlikely perpetrators. However, in a world of limited resources, those most intent on protecting children must focus their efforts on circumstances that expose children to the greatest risk. Those worrisome circumstances come into decidedly sharper view in a study by medical researchers from Baylor College of Medicine in Houston and from the University of Queensland in Australia.

Analyzing data collected for children born in the Brisbane maternity hospital between 1981 and 1984, the researchers uncover a pattern that makes even more imperative a practice that pediatricians have strongly encouraged for nutritional and immunological reasons: namely, maternal breastfeeding. For when the American and Australian scholars looked for statistical predictors of maternal abuse or neglect of children, they discovered “an inverse relationship between breastfeeding duration and maternally perpetrated maltreatment [of young children].” Whether looking at emotional abuse, physical abuse, or neglect, the researchers find the same telling pattern: “The prevalence of maternal maltreatment increased as the duration of breastfeeding decreased, for all maltreatment subtypes examined separately or in combination.”

The effect of breastfeeding indeed looms large: using a multivariable statistical model, the authors calculate that “for nonbreastfed children, the adjusted O[dds]R[atio] for maternally perpetrated maltreatment was 2.6.” In other words, mothers who do not breastfeed their children are more than two and a half times more likely to abuse or neglect their children than are mothers who do breastfeed their children. When looking just at maternal neglect of young children, the researchers report “a nearly fourfold increase in the odds for nonbreastfed children.”

As the researchers parse their data, they identify a number of “other variables that were independently associated with maternal maltreatment,” including “unmarried status” (Unadjusted Odds Ratio of 1.7; Adjusted Odds Ratio of 1.4) and “low maternal education” (Unadjusted Odds Ratio of 2.1; Adjusted Odds Ratio of 1.6).

But it is the inverse relationship between breastfeeding and maternal maltreatment that holds the researchers’ interest. Trying to explain this relationship, the authors note that “suckling results in peripheral and central production of the neuromodulatory hormone oxytocin,” a biochemical manifesting “a broad range of central effects [that have been] characterized in both animal and human studies as the ‘calm and connection’ response of the parasympathetic nervous system.” It thus appears that “oxytocin helps to prepare the central nervous system for the long-term endeavor of child-rearing.”

Regardless of the biochemistry involved, breastfeeding can deliver its positive benefits only when it happens. It distresses the authors that while 74 percent of new American mothers initiate breastfeeding, “only 42% of mothers in the United States are still breastfeeding by 6 months and only 11% are breastfeeding exclusively, as recommended by the American Academy of Pediatrics.” It alarms the Baylor and Queensland scholars that “breastfeeding rates [run] lowest among those at highest risk for maltreatment (e.g., unmarried women with low levels of education.” Such low levels of breastfeeding among such high-risk mothers merit immediate attention, these scholars believe, at a time when “nationwide data in the United States indicate that, in almost 60% of substantiated [child-maltreatment] cases, the mother is an identified perpetrator.”

The authors believe that the time is past to recognize breastfeeding as “a relatively simple and cost-effective . . . means of strengthening the relationship between a mother and her child. This overarching goal would be best accomplished by promoting parent education and long-term marital stability and by providing economic and social support for new mothers who choose to stay at home with their infants.”